We set up the MSF Access Campaign in 1999 to push for access to, and the development of, life-saving and life-prolonging medicines, diagnostic tests and vaccines for people in our programmes and beyond.

Based in Brussels, MSF Analysis intends to stimulate reflection and debate on humanitarian topics organised around the themes of migration, refugees, aid access, health policy and the environment in which aid operates.

Our medical guidelines are based on scientific data collected from MSF’s experiences, the World Health Organization (WHO), other renowned international medical institutions, and medical and scientific journals.

Providing epidemiological expertise to underpin our operations, conducting research and training to support our goal of providing medical aid in areas where people are affected by conflict, epidemics, disasters, or excluded from health care.

Evaluation Units have been established in Vienna, Stockholm, and Paris, assessing the potential and limitations of medical humanitarian action, thereby enhancing the effectiveness of our medical humanitarian work.

The MSF Paediatric Days is an event for paediatric field staff, policy makers and academia to exchange ideas, align efforts, inspire and share frontline research to advance urgent paediatric issues of direct concern for the humanitarian field.

A collaborative, patients’ needs-driven, non-profit drug research and development organisation that is developing new treatments for neglected diseases, founded in 2003 by seven organisations from around the world.

A double-tap* barrel bombing on an MSF-supported hospital in a besieged zone in the northern Homs governorate of Syria, caused 7 deaths, the partial destruction of the hospital and an influx of 47 wounded patients needing to be transferred to nearby field hospitals, some of whom died en route.

At around 09:40 local time on Saturday 28 November, a barrel bomb was dropped from a helicopter on a populated area of Al Zafarana town, to the north east of Homs city in Syria, killing a man and a young girl, and wounding 16 people. These patients were admitted to the Al Zafarana hospital in the mass casualty influx.

Soon after, another barrel bomb landed next to the hospital, causing damage to the kidney dialysis unit. Then 40 minutes later, at around 10:30am local time, when the wounded from the first bomb were being treated in the hospital, two further barrel bombs were dropped right by the front entrance, killing one bystander, and wounding 31 of the patients under treatment and medical staff, including two paramedics working for the Syrian Civil Defence ambulance service, one of whom sustained critically serious head injuries. The second blast also caused partial destruction of the hospital.

The most critically wounded patients were transferred to three nearby hospitals. The 16 from the initial influx were immediately sent to one hospital. A second facility received 21 injured and 4 who arrived dead, having died on the journey, and the third facility received 10 injured and 1 dead-on-arrival.

In total these bombings have killed seven and wounded 47 people. Half of the wounded (23 out of 47 people) were women, and children under 15 years old.

“This bombing shows all the signs of a double-tap, where one area is bombed and then a second bombing hits the paramedic response teams or the nearest hospital providing care,” says Brice de le Vingne, Director of Operations for MSF. “This double-tap tactic shows a level of calculated destruction that can scarcely be imagined.”

It is unclear at this stage whether the hospital will be able to resume activities after the bombing. Sections of the outside wall have been blown in by the blast and the dialysis unit and part of the medical stock have been destroyed. MSF is offering support to repair or relocate the facility, and is preparing to send the hospital team essential medical supplies should it be possible for them to continue operating.

“This makeshift hospital was providing a lifeline of care to around 40,000 people in Al Zafarana town and the surroundings,” says de le Vingne. “It is already a tragedy that seven people, including a small girl, have been killed, but if the hospital has to close down or reduce activities, that is a double tragedy for the people living under the permanent threat of war, with nowhere else to turn for medical assistance.”

MSF once again reiterates its call that all efforts should be taken by all parties to the Syrian war to avoid civilians and civilian infrastructure, including hospitals and ambulances. The multiplication of these atrocious attacks, with overwhelmingly high numbers of civilians, including women, children and medical staff, wounded or killed, must cease.

MSF operates six medical facilities in the north of Syria and directly supports more than 150 health posts and field hospitals throughout the country, with a particular focus on the besieged areas. These are mostly makeshift facilities with no MSF staff present, where MSF provides both material support and distance training support to help the Syrian medics cope with the extreme medical needs. This support network has been built up over the past four years.

* A double-tap attack refers to an attack where one area is bombed, then either more bombing follows on the same area when the rescue teams arrive, or the nearest hospital is bombed when the wounded are transferred there for treatment.

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